NPI | 1346621513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 309332) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 209625) |
Enumeration Date | 2015-06-14 |
Last Update Date | 2019-01-14 |